This is Steven Salzberg's blog on genomics, pseudoscience, medical breakthroughs, higher education, and other topics, including skepticism about unscientific medical practices. Here's where I can say what I really think about abuses and distortions of science, wherever I see them.

NCCAM and NIH support "magnet field therapy"?

My recent blog on Ayurveda and NIH, which was mostly about NCCAM (the National Center for Complementary and Alternative Medicine at NIH), has been getting a lot of attention, so I'm starting a new thread here. Some of the responses I'm getting seem to think it's a good idea to fund "alternative" medicines. I would argue strenuously that this is not so. NIH funds research based on scientific evidence - there is no such thing as "alternative" science. Likewise, the phrase "complementary and alternative medicine" is misleading because it uses the term "medicine" - but all modern medicine is based on well-grounded, firmly established scientific principles. If an herbal extract is effective at treating a disease, then it's a medicine - not an "alternative" medicine. If it doesn't work, then it's just an herb. So I did a quick search of what NCCAM is funding, and picked one (yes, I'm picking on one) grant to show the kind of crap they support. Here it is: NCCAM grant R21AT003293-01A1, "Carpal Tunnel Syndrome and Static Magnetic Field Therapy." The investigator, Agatha Colbert, is at a place called the Helfgott Research Institute. She wants to study whether "magnetic field therapy" can treat carpal tunnel syndrome - yes, that's magnets. There is no evidence at all that magnets cure any disease, including CTS, but that doesn't matter for an NCCAM award, apparently. I suppose I could launch into a diatribe about the superstitions surrounding the use of magnets as therapy, but I'll avoid that. There isn't even a mechanism by which magnets could work - this is just magical thinking. Proponents of magnets sometimes say they improve blood flow, but this is nonsense - the iron in blood is not attracted by magnets (it's not in the right form for that). It's just a superstition, and having a study funded by NCCAM will do little other than allow the purveyors of "magnetic therapy" to use this as a sales tool that will help them fool a few more people with this modern form of snake oil. By the way, the Helfgott Institute is dedicated to naturopathy, "Chinese medicine" (whatever the heck that is), and "energy medicine" (ditto). I'm sure they are very happy that NIH has set aside funds for this kind of nonsense. NCCAM is an embarrassment.

6 comments:

Apparently, we are entering the age of "personalized alternative medicine." My impression of this FOA is that we are supposed to use "omics" data to explain all of the negative results from NCCAM-funded studies.

No, I'd not seen this one, and thanks for pointing it out. NCCAM is just dressing up their pseudoscience here in the trappings of real science. This program is just a fishing expedition to try and get someone (not likely to be a serious scientist) to use genome data, but it isn't clear what they're supposed to find. It even states that "Trials need not exhibit significant differences between arms. This analysis may be applied to studies with negative results as a function of high patient variability in the treatment arm...." What nonsense! So you can take a study with negative results and re-analyze any chance variation in those results, and then try to find a correlation with some genomic data - this is a recipe for bad science.

Professor Salzberg will no doubt be disappointed to learn of a growing body of scientific literature that demonstrates modulation of microvasculature as one of the possible biological mechanisms for the effects observed with static magnetic field therapy.1-8. In fact, a recently completed NCCAM funded study through the Biomedical Engineering Department of the University of Virginia, found that not only do magnetic fields influence blood flow by modifying blood vessel diameters, but that the application of a magnetic field gradient of 20-60mT/0.7cm results in structural remodeling of the microvasculature as well.6

As for my carpal tunnel/magnet study, I am grateful that our esteemed colleagues at NCCAM/NIH judged the scientific merit of this project worthy of funding. Magnet therapy as a self-care intervention is commonly used by the general public. (Data Research-2000 reported $350 million in sales of therapeutic magnets in the USA and $4 billion worldwide in 1999). If our rigorous clinical trial determines that the application of a permanent magnet over the carpal canal improves median nerve conduction and provides symptomatic relief, then we will have found an inexpensive, non-invasive means of helping millions of people who suffer from carpal tunnel syndrome. If on the other hand, we find no beneficial effect, we can inform the general public of that fact. In either case our scientific understanding of magnet therapy will be substantially advanced .

Agatha Colbert demonstrates at least two logical fallacies in her response. First, she states that "Magnet therapy as a self-care intervention is commonly used by the general public." But the use of any therapy by the general public is not evidence for its effectiveness; indeed, countless examples can be found - today and historically - of ineffective and even harmful treatments that are widely used. This fallacy is sometimes called the "argument from authority."

Second, she cites a trial that showed small changes in blood flow (in rabbits) under a strong magnetic field. This is what is called the "moving goalpost" logical fallacy, and here is why: the study she cites from UVA (her reference 6, read it here) suggests nothing about "nerve conduction" being improved by magnets. What it in fact showed was a narrowing of blood vessels - exactly the opposite effect of that claimed by proponents of magnetic field therapy, who argue that increased blood flow results from the magnets. So it appears that Dr. Colbert is arguing that any effect - even decreased blood flow - is support for her hypothesis.

There are other problems with these studies, but I think I've said enough. For a good discussion of logical fallacies, see The Skeptics Guide to the Universe link on my blog homepage.

Hello Steven,I recently posted a review of NCCAM's review of magnetic therapy and where it missed the boat for the promising research into static magnetic fields for the treatment of pain. Quadrapolar magnets are a magnetic field gradient generating device that the research shows have a physiological effect not shared by the ubiquitous bipolar magnets.

We funded our own clinical trial into the effects of quadrapolar magnets on osteoarthritis of the knee that did show efficacy over placebo that should be published soon. It was only a pilot trial with low numbers, but the fact remains this is a promising area for further research. The last 10-20 years has made very little progress in the treatment of non-cancer chronic pain, despite millions being spent as per the recent review by Turk in the Lancet. In fact many large pharmaceutical companies are vacating the area, so this is a very complex and difficult area even for the best researchers.

Turk also noted there is a crucial need for a combination of therapies to tackle this pervasive problem. We also own a medical clinic that specialises in treating chronic and complex pain and see remarkable changes in chronic pain sufferers using Q magnets as an adjunct in therapy every week.

Magnet field therapy carries a lot of baggage I agree, but there are areas within it that show promise that do warrant further investigation.